Care Home: Barrington Lodge Care Home

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What the care home does well Barrington Lodge continues to provide a homely environment for those who live there. The residents said the staff are caring and responded to their needs. And discussion with families confirmed that they are satisfied with the services provided in the home. The home has clear admission procedures, assessments and care plans to make sure it can meet the needs of people who live in the home. A range of social activities is provided to ensure that residents have the opportunity for stimulation and to take part in activities and outings that they like. The home is well maintained and any repairs are dealt with promptly. The home is run with an open door policy and the manager and staff has a good rapport with visiting relatives, which gives the home a welcoming feel. Observations confirmed that staff interact with residents in a professional manner and it was positive to note that they shared an odd joke or too. The manager responds to all alerts made under safeguarding adult`s procedures and ensures that appropriate actions are taken. In addition to this the manager was receptive to advice offered during the visits and took immediate steps to address issues relating to fire safety. What has improved since the last inspection? The homes occupancy has increased and the manager believed that this was due to the services being improved and consequently becoming more established within the community. More information is available in the information packs for anyone making an enquiry about the home. Care has become more person centred and some staff has received specific training in working with people who have dementia. There has been a greater focus on providing activities that provide stimulation to residents. In some rooms furniture and carpets have been replaced and bathrooms have been refurbished. Staffing levels have been improved to give sufficient cover on each floor, which ensures that resident`s needs are met. CARE HOMES FOR OLDER PEOPLE Barrington Lodge Care Home St Andrews Road Bishop Auckland Durham DL14 6XX Lead Inspector Clifford Renwick Key Unannounced Inspection 09:00 14 & 20th August 2008 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barrington Lodge Care Home Address St Andrews Road Bishop Auckland Durham DL14 6XX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01388 662322 01388 605405 barrington.lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Sheryl Goodfellow (in the process of being registered). Care Home 70 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (40), Physical disability (6) of places Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, maximum number of places: 30 Physical Disability - Code PD, maximum number of places: 6 Old age, not falling within any other category - Code OP, maximum number of places: 40 The maximum number of service users who can be accommodated is: 70 15th August 2007 2. Date of last inspection Brief Description of the Service: Barrington Lodge is a purpose built 70 bedded home located on the outskirts of Bishop Auckland. Accommodation is provided on 2 floors. All rooms are single en-suite and the home caters for elderly service users who require nursing or residential care. There is a 40 bedded unit for service users with general needs and a 30 bedded unit for service users with mental health needs. Several spacious lounge and dining areas are also available. The home is located in a quiet cul -de- sac and has pleasant gardens. It is close to the town centre and other local facilities. The fees charged at the time of this inspection were between £437.50 and £603.98 per week. This does not include hairdressing, chiropody, newspapers, personal toiletries and clothing. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. Before the visit: We looked at: • • • • • Information we have received since the last visits in August 2007. How the service dealt with any complaints & concerns since the last visit. Any changes to how the service is run. The provider’s view of how well they care for people. The provider in the annual quality assurance assessment (AQAA) submitted information to confirm what they are doing in the service. The Visit: An unannounced visit was made on the 14th August 2008, and an announced visit was carried out on 20th August 2008. During the visit we: • • • • • • • • • • • Talked with people who live in the home and also staff who were on duty. Held discussion with the manager and operations manager. Observed staff working practices. Looked at information about the people who live in the home & how well their needs are met. Looked at other records, which must be kept in relation health and safety and staffing. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around all areas of the home to make sure it was well maintained, safe and free of any hazards. Checked what improvements had been made since the last visit. Spoke with staff. We also gathered information from looking at care records to assess how staff supports the residents with their assessed needs. We focused upon looking at care files for 4 residents as a part of the inspection we refer to this as “case tracking”. And this involves looking at all records of the care for a named individual. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 6 We told the manager what we had found. The people who live in this home prefer to be known as residents therefore this term of reference is used throughout the report. What the service does well: What has improved since the last inspection? The homes occupancy has increased and the manager believed that this was due to the services being improved and consequently becoming more established within the community. More information is available in the information packs for anyone making an enquiry about the home. Care has become more person centred and some staff has received specific training in working with people who have dementia. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 7 There has been a greater focus on providing activities that provide stimulation to residents. In some rooms furniture and carpets have been replaced and bathrooms have been refurbished. Staffing levels have been improved to give sufficient cover on each floor, which ensures that resident’s needs are met. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment is completed prior to a place being offered in the home and this ensures that only those people whose needs can be met are admitted. Individual contracts clearly set out the terms and conditions so residents know what services they are to receive. Intermediate care is not provided therefore this standard was not assessed. EVIDENCE: In discussion with the manager it was confirmed that once an enquiry has been made about the home a process of assessment commences. The manager completes a document that is known as the pre admission assessment and this is used to assess whether a persons need’s can be met in the home. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 10 Other information is gathered as part of the assessment process and this can include assessment information from social services as well as health services. Evidence is available in the resident’s files to confirm that a comprehensive assessment is always undertaken. A contract/ terms and conditions of residence is issued and this is signed by the resident/ their families or representative and a copy is kept on their individual file. This clearly sets out their rights and responsibilities and what services they are to receive whilst residing in the home. In discussion with one relative they said that they had looked at 3 other residential homes before choosing this one and they were pleased that they had chosen this home. They went on to say that their relative had now lived here for three years and they continued to be satisfied with the services that are provided. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Though written care plans are in place, these need further development to ensure that people receive care in a way that they prefer. Nevertheless, health care needs are effectively met and medication administration follows good practice. These ensure that residents’ general health and wellbeing are safeguarded and promoted. Furthermore, excellent staff interactions with residents confirms that residents are treated with dignity and respect at all times. EVIDENCE: Residents living at Barrington Lodge have individual written plans of care in place and information is being maintained about the individual residents health and personal care needs in these plans. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 12 Four care plans and care files were viewed as part of a case tracking process which involved looking at all written records held on a resident and from this assessing how individual needs are being met. One person has been assessed as having some problems with eating and staff have put a plan in place to deal with this to ensure that the resident receives nourishing meals. This is not clearly recorded in the care plan. Another person has some difficulty with communicating by speech but can indicate their needs. Staff are aware of this and have strategies in place to support this person in a professional and positive manner. These positive practices carried out by staff however are not included in the care plan and lack some detail as to why staff support this person in a particular way. Each residents care file does contain a lot of information that has been collated by staff and this includes a medical history and any support offered by health professionals. The files also include information about mobility and a risk assessment is completed on moving and handling to ensure that people are supported in the correct manner and with the correct equipment. Staff carries out monthly evaluations but these are not always dated and not always entered on the pre printed evaluation sheet. However information about progress was being recorded on a different pre printed sheet. Some of the care plans were not fully dated so it was difficult to determine when the care plan had been started. Though the care plans do not always contain full details of the care offered discussions with staff and observations of staff practices confirmed that residents individual needs are being met. Staff have a good understanding of the people they are caring for and though the files do not contain sufficient information about a persons previous life history. Staff have a lot of information about a persons background prior to moving into the home and they use this as part of their work. It was positive to note that a number of the residents who have needs related to dementia retain a key for their bedroom door and are encouraged to use these. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 13 Staff refer to residents by their chosen form of address and this was observed during the visit. Personal care tasks are carried out in the privacy of a resident’s bedroom. Medication records were not viewed but administration of medicines were observed over two periods and this confirmed that this was satisfactory. Discussion was held with the manager about the ordering process for medicine’s as staff must see a copy of the prescription issued by the GP and a copy be kept before sending to the pharmacist for dispensing. Presently this does not happen with the prescription being sent directly from the GP to the dispensing pharmacist, this leaves the potential for an error to occur, as staff cannot verify what the GP has prescribed. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lead fulfilling lifestyles through exercising choice and control over how they spend their day. People’s lifestyle is good with regular contact being maintained with relatives and friends. Generally the residents receive a wholesome appealing balanced diet though the practices of how meals are served require reviewing. EVIDENCE: The home employs an activities co-ordinator and on the day of the visit an excursion had been arranged for 4 residents accompanied by staff to visit Aysgarth Falls and its museum. Discussion was held with the residents following this excursion and they all confirmed that it had been a good day out. They went on to say that they had had a good laugh when they had visited the museum. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 15 The residents stated that they liked going out and another excursion had been arranged for later in the month to go to South Shields. Activities continue to take place both inside and outside of the home. The indoor activities include bingo, board games, dominoes, skittles and carpet bowls. Outside entertainers visit the home from time to time and the day before the visit an entertainer had performed a musical show in the home. The activities organiser continues to spend time with people on an individual basis so that she can find out which activities they like. There are no restrictions on visiting the home and relatives said that they can visit at any time and that they are always made to feel welcome. One relative said, “When we visit the staff are always friendly and always give us an update on our relatives care”. Another relative said that he had been visiting the home for 3 years and he had seen a number of improvements. A number of the residents choose to spend time in their own bedroom following their own routines. Another resident likes to have a cigarette and makes use of the front garden area whenever they want to smoke. Throughout the home there are 4 dining rooms 2 on each floor and lunch was taken in a different dining room on each floor on two occasions. During lunch the atmosphere was relaxed and unhurried however on the first floor dining room where residents have a dementia type illness there was a long wait from sitting down to the meal being served. The tables were not fully set when the meal was served and there were no tablecloths, condiments or serviettes. Staff offered residents choice of a cold drink but as there were no jugs on the table there were no visual cues available to guide people in making their choice. The meals are served from trolleys that are sent up from the kitchen. The meal that was served on the first visit was a beef burger in a bun with salad. Whilst serving the meal staff ran out of salad and had to obtain this from another dining room as insufficient food had been provided on the trolley. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 16 The meal itself did not look appealing and the salad was plain consisting of finely chopped green lettuce and other green vegetables. This would have tasted better and looked well if other vegetables such as tomatoes and peppers, spring onions and a salad dressing had been available. For some people the meal was not appropriate and though alternative meals were provided to some residents the menus on display did not show what alternatives were available. All of the menus available in the home are displayed in a folder that is held by a chain to the outside doorframe of each dining room. This is not helpful, as you have to stand outside the dining room to read the menus. On the second visit lunch was taken in a ground floor dining room and the tables were nicely set but again there was a long wait (over 20 minutes) between sitting down and the meal being served. And staff ran out of crockery for the dessert. In discussion with staff they explained that the delay was due to having to share the trolley with the other ground floor dining room and any delays there have a “knock on effect”. The meal on the second day of the visit was tasty, well presented and sufficient in quantity and better than the meal that was taken on the first day of the visit. The situations experienced during the meal on both visits were not satisfactory and were discussed with the manager who was advised of the need to review the mealtime practices. It was positive to note that during the meal staff offered assistance to residents to eat their meal and this was carried out in a courteous and discreet manner. As the inspection progressed the manager confirmed that changes had been made to the menus to show the alternative meals had been included and the other matters raised were now being reviewed. In discussion with the residents they confirmed that they liked the food that was served in the home and stated that there was always enough to eat. Discussion was also held with relatives who confirmed that when they have visited at mealtimes they have noted that the meals were well presented and of good quality. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 17 Discussion held with the cook confirmed that she had a good understanding of the resident’s dietary needs. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear accessible complaints procedure gives residents and their relative’s confidence that they will be listened to and taken seriously. Furthermore it provides information that is effectively used to improve the service. The manager and staff have a good understanding of local adult protection procedures, which helps to ensure the protection of residents from abuse. EVIDENCE: The manager has ensured that any complaints or issues that relate to safeguarding adults are dealt with quickly. Any complaints that are made are documented and the complainant is kept up to date with any actions taken by the home. A “whistle blowing” policy is in place and this supports staff to raise any areas of concern that they may have. This is backed up with a flow chart to show what you should do and whom to report to if you have a concern about the care of the residents. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 19 In house training has been provided to staff on “safeguarding” and a document that is termed Protection of Vulnerable Adults is available to staff. The home is using Durham Social Services policies and procedures for reporting any incidents and also for any investigations that need to be carried out. The manager has notified the commission in a timely manner whenever an incident has occurred in the home and these have been dealt with appropriately. And have involved representatives from both social services and the commission. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean, well maintained and has a good range of facilities. This promotes a positive image for residents. However wedging open fire doors and storing inappropriate items in bathrooms potentially compromise’s the health and safety of residents and staff. EVIDENCE: During both visits all areas of the home were viewed and this included bathrooms, bedrooms and communal areas. The home employ a maintenance person who has responsibility for dealing day to day repairs and these are tackled promptly to ensure that the home is kept in good order. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 21 The double glazed units in three of the bedrooms had misted up and were due to be replaced with new windows. A good standard of hygiene and cleanliness is in place and with the exception of 3 bedrooms there were no unpleasant odours. The manager explained that due to the extreme behavioural problems of the occupants of these 3 rooms there were a number of issues that needed to be dealt with. For those rooms that had an odour the manager explained that a strategy was in place that included a thorough cleaning process and also changing the type of floor covering that was in the room. The manager stated that this would assist in eradicating the odour. Some of the bedroom doors are fitted with a device that is linked to the fire alarm system and allows the door to stay open without compromising fire safety. Three bedroom doors were wedged open with a variety of items (e.g. a wedge, a wheelchair) and this compromised the fire safety of the people who both live and work in the home. This was discussed with the manager who was issued with an immediate requirement notice advising of what actions must be taken and this is discussed more fully in sections 31 – 38 of this report. At the time of the visit one bathroom had been taken out of use and was being used for storage this meant that the ratio of bathing facilities had been reduced. The manager was advised that this bathroom must be brought back into use. All of the other bathrooms were viewed and these were being used to store a variety of items such as clothing, a mattress, nebuliser, walking frames, linen skips, items of lifting equipment and toiletries. This was discussed with the manager who was advised that health and safety was being compromised and appropriate storage space needed to be arranged for these items. Communal lounges are comfortable and well set out and a variety of other seating areas are available throughout the home that residents can use. An external garden area has seats and residents and their visitor’s too use this. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient to ensure that residents’ needs are met. Furthermore staff receives sufficient training to support them in their work, to ensure residents receive good quality care. Robust recruitment procedures are in to prevent unsuitable people being employed. EVIDENCE: During the inspection there were sufficient staff on duty to meet the needs of the residents. In discussion with the manager she confirmed that many of the care staff have worked in the home for a long time and this has created stability within the staff team. In addition to the care staff a qualified nurse/s who takes responsibility for managing the day-to-day business is allocated on each floor. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 23 There are normally 2 qualified nurses allocated to each floor but due to sickness at the time of the visit there was only one nurse working with 3 care staff on one floor. This did not appear to have an impact on the service though the nurse was kept extremely busy during the shift. One of the staff is a moving and handling trainer and carries out regular training for all staff. And on the day of the visit was carrying out refresher training. Just fewer than 50 of the staff team have completed NVQ Level 2 training and 12 staff is currently enrolling on a variety of NVQ Level 2 training courses. Two of the staff has carried out training in Dementia Care Mapping and this training is designed as a way of improving the care given to people with dementia. Discussion with the manager confirmed that staff is commencing on person centred dementia care training. Which means that the care process will go beyond meeting basic physical needs. But will also focus upon each individual making the fullest possible use of his or her abilities to have a fulfilling lifestyle whilst living in the home. There were some issues regarding the training records that confirmed when staff received fire training and this is discussed more fully in sections 31 – 38 of this report. Staff files for all persons employed since the last were available during the inspection but these were not looked at in detail. The manager confirmed that there have been no changes in the recruitment procedures and these continue to be robust. Each person employed has to provide a full employment history with an explanation of any gaps in employment. Two references are sought and a criminal record bureau check is carried out. And in addition to this staff have to sign a health declaration confirming that they are physically and mentally fit for the post they are applying for. Discussion held with staff confirmed that they like working in the home, and a number of staff were positive about the changes that had been made by the manager during the last 12 months. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to have an acting manager in place who is experienced and is a qualified nurse and provides support and guidance to staff, the people who live in the home and their visitors. The lack of regular fire training for staff can compromise the health and safety of people who both live and work in the home. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 25 EVIDENCE: The acting manager has managed this service for 12 months and is currently in the process of submitting an application to the commission to be the registered manager. The manager has worked for the company for several years and has previously managed other care services. The manager has implemented a number of positive changes in order to ensure that the home is run in the best interests of the residents. The manager takes responsibility for supervising all of the qualified staff (nurses) and delegate’s responsibility for supervision of care staff to the nurses. Records of supervision were seen and these confirmed that supervisions are not always carried out 6 times yearly. A number of supervisions had been planned to take place in July but these had not been done. The last recorded dates for supervision taken place were in April of this year. Monies are held on behalf of the residents and good records are in place and monthly as well as periodical audits are carried out by head office to ensure that money is being handled correctly. Good records are maintained of any accidents in the home and the manager notifies the commission in a timely manner of any reportable incidents/accidents. Fire training records that include fire drills and fire instruction are not up to date. And it could not be confirmed if staff are taking part in regular fire drills and fire instruction training. One record of a fire drill was recorded on a piece of paper and dated as being carried out in August this year. However there was no information to confirm what had been covered in the drill, how long it lasted and whether the staff responded in accordance with the homes fire procedures. Discussion with the manager confirmed that fire drills and fire instruction are carried out and the home has a nominated fire warden who also holds responsibility for carrying out training with staff. In discussion it was established that this person would benefit from refresher training in their role as a trainer. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 26 Due to the absence of fire records and that fire safety in the home was being compromised by wedging open bedroom doors (covered in section 19 – 26 of this report) and not all staff were clear when asked of what to do in the event of the fire alarm sounding. An immediate requirement was issued for all staff to take part in at least one fire drill and receive one period of fire instruction training within14 days. The manager addressed this immediately. Good maintenance records are in place and regular tests of the fire equipment are carried out. The acting manager confirmed that all equipment in the home is regularly checked. The maintenance certificates checked were found to be in order. Monthly visits are carried out by the company as part of the ongoing quality assurance within the home. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Timescale for action 31/03/09 2. OP9 13 (2) 3. OP23 23 4. OP38 23 (4) (c) The individual care plans must include sufficient information to demonstrate how staff is meeting assessed needs. These must be reviewed at least monthly and record kept of any change in individual needs. The manager must ensure that 20/08/08 the guidelines as issued by the Royal Pharmaceutical Society are adhered to when ordering medicines. (Immediate) The manager must ensure that 20/08/08 all parts of the home are kept clear and free of hazards. And bathrooms must not be used for storage. (Immediate) All staff must take part in at 28/08/08 least 1 fire drill and receive 1 period of fire instruction within 14 days. (Immediate) Following this staff must continue to receive regular fire drills and fire instruction at a frequency as advised by the fire authority. A record of this must be maintained at all times. At no stage must bedroom doors Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 29 be wedged open. This will ensure that the health and fire safety of residents and staff is not compromised. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. Refer to Standard OP15 OP36 OP38 Good Practice Recommendations The dining room practices should be reviewed as advised within this report. And menus should be designed to include a list of the alternative foods available. Staff should receive formal supervision at least 2 monthly. The manager should submit her application for registration to the commission. Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Barrington Lodge Care Home DS0000000690.V370108.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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